Health and Fitness

How is Severs Disease Managed?

Heel pain is common in both adults and children. In adults by far the most common reason is a condition called plantar fasciitis and in children the most common reason is a condition called Severs disease. Severs disease is the most well known name for this condition which is medically known as Calcaneal apophysitis which is the term that should be probably used as the condition is not a disease and there is a trend to no longer name conditions after people. This problem is a stress injury of the growth plate at the back of the heel bone, so it is only a problem in growing children. Once growth stops in the heel bone, it is no longer an issue and the condition resolves spontaneously.

The typical symptoms of Severs disease is pain at the back and sides of the heel bone, especially during and after sport. The most common ages that this happens is the early teenage years or just before that. It always goes away from around the mid-teenage years. The initial approach to treatment is to use ice after activity to relieve the pain. Cushioned heel raises are also commonly used to protect the area. Of most importance in the management is to manage the loads that the child is putting on the heel bone. This will typically mean that they need to reduce activity levels for a period of time to allow the damage in the heel bone to heal. This can prove a challenge as children like to run around at school and at other activities. As the natural history of Severs disease is to get better on its own eventually the management of those loads and live style is important to keep the pain under control. In the most resistant cases it is sometimes necessary to put the child into a cast or leg brace, just to protect the area and reduce activity.

Doug Parks